You must complete the following questionnaires prior to
your appointment and either bring them with you or fax to
Becky Sheppard at 913-588-0012. Questionnaires
are available on this website or from Becky Sheppard at 913-588-6208.
These forms are mandatory and must be fully completed for
your 1st consultation. No exceptions.
Bring copies of your most recent test results – extremely
important to obtain results from any blood tests done in the
last 12 months
Bring medical records/films
Physician Notes
Detailed history and physical (H&P) explaining course
of disease and treatment recommendations, and reason for
referral
Procedure Notes
Surgical reports
Imaging CD and/ or reports
Chest x-rays
Bone scans
CT scans
MRI scans
Mammograms
Pathology reports
Any materials your doctor has regarding your case or
treatment
Recent lab work such as blood tests done in the last year
Week long or month long food diary
To obtain copies of your medical records
Contact each clinic where you have received care
Sign authorization release form
Pick up records from clinic
Medical records may be faxed to us ahead of time at 913-588-0012
It may take up to a month for a doctor’s’ office
to fax or send records, so start process early
You’ll probably be sent to outpatient lab for blood
work after your initial consult
Do not take vitamin or mineral supplements the morning
of your visit as they may cause inaccurate lab test results
Fasting is recommended only if you have not had
a recent lipid panel in the last year
Bring fruit or juice with you to the lab if you are prone
to becoming weak when having your blood drawn
Inform your oncologist of plans to use intravenous ascorbate
therapy and have their approval
Be well-informed on the role of diet and supplementation
in antioxidant therapy
Beating Cancer with Nutrition by Patrick Quillin
is highly-recommended book for any person diagnosed with
cancer
Be informed of fees associated with visit and be prepared
to pay with cash, check or credit card at time of service. Understand
that alternative medicine fees are not covered under traditional
health insurance plans, including Medicaid and Medicare.
©
The University of Kansas Medical Center